Aortic dissection classification

Aortic dissection Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Aortic dissection from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Special Scenarios
Management during Pregnancy
Case Studies
Case #1

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Sahar Memar Montazerin, M.D.[3]

Overview

Several different classification systems have been used to describe aortic dissections. The systems commonly in use are either based on either the anatomy of the dissection (proximal, distal) or the duration of onset of symptoms (acute, chronic) prior to presentation. DeBakey and Stanford systems are the commonly used classification systems for aortic dissection. European society of cardiology defined another classification system for aortic dissection in 2014.

Classification

• Several classification systems have been suggested for the description of aortic dissection.
• The commonly used classifications for aortic dissection are either based on the timing of the symptoms or the anatomy of the dissection.
• DeBakey and Stanford systems are the commonly used classification systems for aortic dissection.

DeBakey Classification System

The DeBakey system classifies aortic dissection based on anatomy of the aorta. It classifies the dissection according to the intimal tear location.

• Type I - Intimal tear is located in ascending aorta, spreads at least to the aortic arch and often beyond it distally.
• Type II –Intimal tear is located and limited to the ascending aorta.
• Type III – Intimal tear is located in descending aorta, rarely extends proximally.

• Type III A: Dissection limited to the descending thoracic aorta
• Type III B: Dissection extended below the diaphragm

Percentage	60 %	10-15 %	25-30 %
Type	DeBakey I	DeBakey II	DeBakey III
	Stanford A		Stanford B
	Proximal		Distal
Classification of aortic dissection

Stanford Classification System

Stanford classification system is based on the involvement of ascending aorta.

• A = Type I and II DeBakey
• B = Type III Debakey

Dissection of the aorta descendens (3), which starts from the left subclavian artery, reaching to the abdominal aorta (4). Aorta ascendens (1) and aortic arch (2) are not involved.

• Aortic dissection may be classified according to the timing of symptom presentation to the following:
  • Acute (<14 days)
  • Sub-acute (15-90 days)
  • Chronic (>90 days)